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Objectives: Comparing the sensitivity of Contrast-Enhanced Magnetic Resonance Imaging (CEMRI), mammography and ultrasonography in patients with nipple discharge (ND).Methods: We retrospectively evaluated 38 women with ND who underwent mammography, ultrasound and 1.5 T CEMRI between March 2007 and July 2009. Imaging findings, pathological diagnosis and follow-up data (mean follow-up: 20 months) were compared. Sensitivity and specificity values were reckoned. Statistical differences in sensitivity were assessed.Results: 5/38 malignancies (13.2%; 3 invasive, 2 intraductal; 4 ipsilateral, 1 contralateral to ND), and 14/38 High-Risk Lesion (HRL--36.8%; 11 intraductal papillomas, 1 papilloma with LCIS, 1 sclerosing papilloma and 1 atypical intraductal hyperplasia, all ipsilateral) were found. CEMRI identified 5/5 cancers and 13/14 HRL (Overall Sensitivity-OSS = 94.7%; Overall Specificity-OSP = 78.9%). 3/5 cancers (1 invasive, 1 in-situ; 1 invasive contralateral) and 2/14 HRL were detected by CEMRI only. Mammography found 2/5 cancer and 3/14 HRL (OSS = 26.3%; OSP = 94.7%). Ultrasound identified 1/5 cancer and 11/14 HRL (OSS = 63.2%; OSP = 84.2). 1/14 HRL was detected by ultrasound only. Compared with mammography and ultrasound, CEMRI showed statistically significantly higher OSS values (p < 0.0001, p = 0.042 respectively).Conclusion: In women with ND, CEMRI should be recommended when conventional imaging is negative. Unexplained ND could be considered an indication for CEMRI. [ABSTRACT FROM AUTHOR]

Post-cholecystectomy syndrome (PCS) is defined as a complex of heterogeneous symptoms, consisting of upper abdominal pain and dyspepsia, which recur and/or persist after cholecystectomy. Nevertheless, this term is inaccurate, as it encompasses biliary and non-biliary disorders, possibly unrelated to cholecystectomy. Biliarymanifestations of PCS may occur early in the post-operative period, usually because of incomplete surgery (retained calculi in the cystic duct remnant or in the common bile duct) or operative complications, such as bile duct injury and/or bile leakage. A later onset is commonly caused by inflammatory scarring strictures involving the sphincter of Oddi or the common bile duct, recurrent calculi or biliary dyskinesia. The traditional imaging approach for PCS has involved ultrasound and/or CT followed by direct cholangiography, whereas manometry of the sphincter of Oddi and biliary scintigraphy have been reserved for cases of biliary dyskinesia. Because of its capability to provide non-invasive highquality visualisation of the biliary tract, magnetic resonance cholangiopancreatography (MRCP) has been advocated as a reliable imaging tool for assessing patients with suspected PCS and for guiding management decisions. This paper illustrates the rationale for using MRCP, together with the main MRCP biliary findings and diagnostic pitfalls. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: To evaluate the impact on perceived report quality of referring rheumatologists for a chest high-resolution computed tomography (HRCT) structured report (SR) template for patients with connective tissue disease (CTD), compared to the traditional narrative report (NR).Materials and Methods: We retrospectively considered 123 HRCTs in patients with CTD. Three radiologists, blinded to the original NRs they wrote during clinical routine, re-reported each HRCT using an SR dedicated template. We then divided all NR-SR couples into three groups (41 HRCT each). Each group was evaluated by one of three rheumatologists (R1, R2, R3), who expressed their perceived report quality for the respective pools of NRs and SRs in terms of completeness, clarity (both on a 10-points scale), and clinical relevance (on a 5-points scale). The Wilcoxon test and the McNemar test were used for statistical analysis.Results: For each rheumatologist, SR received higher ratings compared to NR for completeness (median ratings: R1, 10 vs. 7; R2, 10 vs. 8; R3, 10 vs. 6, all p < 0.0001), clarity (median ratings: R1, 10 vs. 7; R2, 10 vs. 8; R3, 10 vs. 7, all p < 0.0001), and clinical relevance (median ratings: R1, 5 vs. 4; R2, 5 vs. 4; R3, 5 vs. 1, all p < 0.0001). After rating dichotomization, the use of SR led to a significant increase (p < 0.01) in completeness, clarity, and clinical relevance as compared to NR, except for clarity as perceived by R2 (p = 1).Conclusion: Referring rheumatologists' perceived report quality for structured reporting of HRCT in patients with CTD was superior to narrative reporting. [ABSTRACT FROM AUTHOR]

Introduction Little is known about the structural abnormalities underlying generalized anxiety disorder (GAD). However, there is evidence of larger volumes of dorsomedial prefrontal cortex (Schienle et al, 2011). Also, increased n-acetyl-aspartate in right dorsolateral prefrontal cortex (DLPFC) (Mathew et al, 2004), and hyperactivation in right middle frontal to negative stimuli have been shown in GAD (Blair et al, 2008). Objectives To investigate variations in cortical thickness (CT) in GAD patients versus healthy controls (HCs). Aims GAD patients and matched HCs underwent a 3T magnetic resonance imaging (MRI) session. Methods Structural MRI was acquired from 24 DSM-IV GAD patients (age=41±13.9) and 23 HCs (age=39±13.4). CT was estimated using Freesurfer5.3 (Fischl and Dale, 2000). Results were manually corrected if necessary. We considered 21 regions of interest (ROIs) per hemisphere (4 cingulate, 6 frontal, 3 parietal, 5 temporal, 1 occipital, entorhinal, insula), for each of which a mean CT value was calculated. A t-test was performed for each region, correcting results for multiple comparisons. Results The groups were statistically homogeneous in terms of age, gender, handedness, and IQ (p>0.05). Though ROI volumes were preserved in GAD (p>0,05; Bonferroni corrected), a significantly reduced CT was found in right caudal middle (t(46)=3.621, p=0.015) and right superior frontal (t(46)=3.215, p=0.049) regions. Conclusions The found decreased CT in GAD patients compared to HCs in superior frontal and caudal middle areas (right side) sustains prior neuroimaging findings showing abnormalities in prefrontal cortex. Reduced right frontal CT may be involved in cognitive dysfunction and symptomatology of the disorder. [ABSTRACT FROM AUTHOR]